CLEVELAND, Ohio – The laboratory is white and cold and meticulous, like the calculations trialed within.

Two men -- one in a white shirt, the other in a white lab coat -- stand with black headphones covering their ears.

"Stand by," said the man in the white shirt. That is Adam Bartsch, an Ohio State engineering graduate and former engineer of automotive crash testing.

Bartsch and the man in the white lab coat, Sergey Samorezov, a white-haired mechanical engineer whose expertise includes prototype development, are staring at their linear impactor.

At the end of the linear impactor is a 15 kilogram weight, or ram, padded by foam that is within inches of a football helmet mounted on a Hybrid III crash test dummy head and neck. Located in the mouth of the test dummy's red-dirt colored head is the intelligent mouthguard.

"Ready," Bartsch said. There's a pause for a brief moment. All is quiet.

"Firing," Bartsch said. Twenty-five pounds per square inch of compressed air is released, exploding the weight forward like a sprinter off a block. Then, impact.

The ram connects with the helmet, sending a ringing sound through the air as the head tilts and the helmet moves.

Within 15 milliseconds, the weight collided with the helmet, sending impact data from the intelligent mouthguard to the computer. The sensors detected 40 times the force of gravity or 40 G's. So far in their calculations, 40-60 G's is equivalent to a normal hit in football.

For comparison, standing is 1 G. Hopping off a step is 3 to 4 G's. Plopping down in a chair at the end of the day is about 10 G's.

Adam Bartsch and Sergey Samorezov are co-creators of the intelligent mouthguard that includes nine sensors which collect data on collisions on a football field. (Amanda Harnocz, Northeast Ohio Media Group)

For the last four years, Bartsch and his small team worked to design this mouthguard by sitting with pages of notes and typing thousands of calculations on a computer screen to create every aspect of this test.

Their hope is that this intelligent mouthguard with nine sensors, Bluetooth capability and a 10-hour lithium battery can change how concussions are diagnosed now and in the future.

From subject to objective

Testing players for concussions after suffering a hard hit has long been an inexact science. Coaches have asked players to count fingers, swung a pen in front of their eyes or tried other sideline strategies.

The subjective tests that so many former athletes have gone through, and often still go through, is what the intelligent mouthguard is trying to eliminate. The data collected from nine different sensors is supposed to add real-time objectivity.

Bartsch, a mechanical engineer with a soccer-player physique, is one of the co-inventors of an intelligent mouthguard, along with developers like Samorezov, Edward Benzel, Vincent Miele and Daniel Brett.

The mouthguard's objectivity comes in the form of U-shaped pulses of impact data, which look like waves on the ocean.

"Maybe this person would be concussed or be fine," Bartsch said looking at one of the pulses on his computer. "Maybe they could get a thousand hits like this and never be concussed. This is what we're trying to do. It's really like one giant math problem."

The mouthguard gives the athletic trainer or even a parent the force of each hit in a way that can be consumed by a non-scientist or non-engineer. In time and with more research, Bartsch's team is hoping this real-time data is available on a more advanced app than is currently available.

The data extracted from nine channels comes from the sensors inside the mouthguard.

"The technology isn't really that novel," Bartsch said. "You could build this in your garage. ... If you talk to an engineer, they'd probably just shrug and say, 'Yeah of course you can do that.' ... The novel part is the data we collect and pair it to the clinician's diagnosis. "

From past to present

In the mid-1940s, Colonel John Paul Stapp used to experiment on the effects of human deceleration. He served as his own human crash test dummy, riding in rocket sleds launched at extreme speeds that were suddenly decelerated.

"These all arose out of basic studies of how humans get hurt," Bartsch said.

Bartsch and his team are carrying out the evolution of Stapp's experiments with a highly refined process. For months, the team spends time designing test metrics. They even attempt a sound hypothesis about what will happen before the first laboratory hit occurs.

"Like a lawyer, you never ask a question in which you don't know the answer," Samorezov said. "Before you push the fire button you better know what to expect."

After a series of intensive tests over several days, they head back to their offices. Notebooks are scrutinized, computer data is crunched.

"Right now, we've whacked a bunch of things a bunch of ways," Bartsch said. "We're writing up our data, submitting it and working on what we call our in vitro trials, which are live human trials."

Those trials started when Kent State football players used the team's mouthguards during summer practice. Unlike most mouthguards, Bartsch said players often need sideline assistance to remove the devices because of the tight fit.

A player, though, won't have to worry about its strength. Brett, one of the device's inventors, tested the polymers used in the mouthguard by giving it to a dog for 24 hours. The dog couldn't tear it apart.

But why place the sensors in the mouth? Why not on a helmet or in an earplug or behind the ear, like products that have already been produced? It's simple: all of those things move during impact, Bartsch said. Movement equals erroneous data.

From dollars to G's to CTE

It's taken four years and $1.5 million in funding for the mouthpiece to go from concept to tested product. But it's not yet ready for the open market. Bartsch said if the product were mass produced, he believes it would cost between $99 to $150.

"The work we're doing is important because clinicians have no objective tool to help them identify potentially at-risk athletes," Bartsch said. "In youth sports, if there is an athletic trainer present on the sidelines, studies have shown they identify roughly 50 percent of concussions.

"We are now able to provide clinicians or even non-clinicians, with a second set of eyes to watch everybody. People are getting hit in the head and it's not being noticed. This will notice it."

The team hopes the device can serve as a compliment to the Cleveland Clinic's Concussion Assessment System, created by Jay Alberts. Together, the tools could assess cognitive function, reaction time, balance and other symptoms more objectively.

"With an accurately measured kinematic device that measures collision, we create a bridge between a variety of collisions," Samorezov said. "We create a predictable bridge instead of 'In my opinion and based on my experience, I think I need to pull Johnny off.' It's hard fact that doesn't depend on the weather or somebody's opinion."

Bartsch and Samorezov think that the intelligent mouthguard, combined with the baseline data, will help make diagnosing a concussion both more accurate and easier. A trainer or parent will be able to tell how impaired or not impaired a player is in any contact sport based on the mouthpiece's readings. Cumulative hits will also be tallied, giving a broader look at brain health over time.

Bartsch gave an example of collecting 100 impacts over 20 Gs — a relatively small hit.

There are those three dreaded letters that made the NFL cough up millions. Neuropsychologists such as Bennet Omalu and Ann McKee believe concussions, especially repeated concussions, cause chronic traumatic encephalopathy (CTE).

"I really don't know anything about CTE other than what I've read," Bartsch said. "This could probably be useful in a study in CTE if in fact it's related to how many times you get hit in the head. A device like this would quantify it for you."

Bartsch said he eventually wants to test brain cells and fake skull in a petri dish to figure out how damaging a hit is based on a cellular basis.

That's why in the basement of an engineering building at Case Western, Bartsch and his team have worked to eliminate the variables. They strive to take the subjective and make it objective, to take opinion and make it fact, so one day a hit on the gridiron can be just a bit safer.